Physical Examination:

Breasts, Axillae, and Epitrochlear Nodes. No asymmetry. No Swelling and

tenderness. No masses; nipples without discharge. No axillary or epitrochlear nodes.

Cardiovascular: Adynamic precordium, normal rate regular rhythm, apex beat at the 5 th
ICS LMCL, no murmur

Abdomen: Flabby with no striae or scars. Normal bowel sounds on auscultation with
normoactive bowel sounds (5-6/min) and tympanic. Soft, non tender and not-distended.

Peripheral vascular: Patient is warm, no edema on extremities. No varicosities.

Musculoskeletal: No joint deformities. Good range of motion in hands, wrists, elbows,

shoulder, hips, spine, knees, and ankles. Normal muscle tone and muscle strength of
4/5.

Nervous system: Well oriented to time, place and person. Comprehension and
understanding are good. Memory for recent and remote events are also good.
Judgement and insight are intact. No anxiety or agitation. Cranial nerves II – XII are all
intact.

Differential Diagnosis:

1. Dengue

RULE IN RULE OUT

Fever Calf tenderness
Chills and Rigors Conjunctival congestion
Headache
Vomiting
Body pain